Adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided versus empirical chemotherapy in unresectable non-small cell lung cancer.

Moon, Yong Wha; Sohn, Joo Hyuk; Kim, Yong Tai; Chang, Hyun; Jeong, Jae Heon; Lee, Young Joo; Chang, Joon; Kim, Se Kyu; Jung, Minkyu; Hong, Soojung; Choi, Sung Ho; Kim, Joo-Hang
Anticancer research
2009Oct ; 29 ( 10 ) :4243-9.
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Moon, Yong Wha -
Sohn, Joo Hyuk -
Kim, Yong Tai -
Chang, Hyun -
Jeong, Jae Heon -
Lee, Young Joo -
Chang, Joon -
Kim, Se Kyu -
Jung, Minkyu -
Hong, Soojung -
Choi, Sung Ho -
Kim, Joo-Hang -
ABSTRACT
BACKGROUND: We retrospectively compared adenosine triphosphate-based chemotherapy response assay (ATP-CRA)-guided and empirical chemotherapies for unresectable non-small cell lung cancer (NSCLC) in this case-control study. PATIENTS AND

METHODS: Unresectable NSCLC patients receiving ATP-CRA-guided platinum-based doublets as first-line therapy were enrolled as cases (n=27; 14 platinum-sensitive and 13 platinum-resistant patients). Performance status, stage, and chemotherapeutic regimen-matched patients receiving empirical chemotherapy were selected from the retrospective database as controls (n=93) in a case to control ratio of approximately 1:3.

RESULTS: Response rate and survival (progression-free; overall) in both groups were not significantly different. However, the platinum-sensitive subgroup by ATP-CRA showed a higher response rate than the empirical group (71 versus 38%; p=0.023) with a trend toward longer progression-free survival (8.7 versus 4.8 months for platinum-sensitive versus empirical; p=0.223) and overall survival (not reached versus 12.6 months for platinum-sensitive versus empirical for p=0.134). CONCLUSION: ATP-CRA may be helpful in selecting platinum-responsive patients in unresectable NSCLC. We consider that nonplatinum doublets in platinum-resistant patients by ATP-CRA may be a more adapted approach than platinum-based doublets in future clinical trials.
Non-small cell lung cancer, in vitro assay-guided chemotherapy, empirical chemotherapy
MESH
Adenosine Triphosphate/metabolism, Adult, Aged, Carcinoma, Non-Small-Cell Lung/*drug therapy/metabolism, Disease-Free Survival, Drug Screening Assays, Antitumor/*methods, Female, Humans, Lung Neoplasms/*drug therapy/metabolism, Male, Middle Aged, Prospective Studies, Retrospective Studies, Survival Rate
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In conclusion, although ATP-CRA-guided chemotherapy did not show superior efficacy compared to empirical chemotherapy in unresectable NSCLC, ATP-CRA may be helpful in selecting platinum-responsive patients.
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